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Questions and Answers
What percentage of live births are affected by congenital anomalies?
What percentage of live births are affected by congenital anomalies?
Which of the following is the most common congenital anomaly?
Which of the following is the most common congenital anomaly?
What is a known risk factor for congenital anomalies?
What is a known risk factor for congenital anomalies?
Which of these anomalies is classified under central nervous system anomalies?
Which of these anomalies is classified under central nervous system anomalies?
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Which congenital anomaly is found with other congenital conditions and is often associated with defects at birth?
Which congenital anomaly is found with other congenital conditions and is often associated with defects at birth?
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What proportion of congenital defects have no identifiable cause?
What proportion of congenital defects have no identifiable cause?
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Which of the following is NOT a gastrointestinal system anomaly?
Which of the following is NOT a gastrointestinal system anomaly?
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Which condition is classified as a respiratory system anomaly?
Which condition is classified as a respiratory system anomaly?
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What is the leading cause of infant deaths under one year of age?
What is the leading cause of infant deaths under one year of age?
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What is the most common bladder anomaly?
What is the most common bladder anomaly?
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In which population is exstrophy of the bladder more prevalent?
In which population is exstrophy of the bladder more prevalent?
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What is the primary nursing theory used to support families with a newborn with congenital anomalies?
What is the primary nursing theory used to support families with a newborn with congenital anomalies?
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What immediate action should be taken for an infant with exstrophy of the bladder?
What immediate action should be taken for an infant with exstrophy of the bladder?
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What psychological response might parents exhibit upon seeing their newborn with congenital anomalies?
What psychological response might parents exhibit upon seeing their newborn with congenital anomalies?
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How soon after birth is surgical closure of the bladder typically performed for exstrophy?
How soon after birth is surgical closure of the bladder typically performed for exstrophy?
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Which aspect of caring is NOT part of the Caring Theory framework for supporting families?
Which aspect of caring is NOT part of the Caring Theory framework for supporting families?
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What emotional response might parents experience related to their newborn's congenital anomalies?
What emotional response might parents experience related to their newborn's congenital anomalies?
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What is a significant role of healthcare providers when dealing with families of newborns with congenital anomalies?
What is a significant role of healthcare providers when dealing with families of newborns with congenital anomalies?
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What is the type of surgical repair for exstrophy of the bladder?
What is the type of surgical repair for exstrophy of the bladder?
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What is a common nursing intervention for a patient experiencing diaphragmatic hernia?
What is a common nursing intervention for a patient experiencing diaphragmatic hernia?
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What is the most severe neural tube defect characterized by the absence of both cerebral hemispheres?
What is the most severe neural tube defect characterized by the absence of both cerebral hemispheres?
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What is the primary treatment for brain and meninges herniation in infants?
What is the primary treatment for brain and meninges herniation in infants?
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Which sign is considered a signature indicator of choanal atresia?
Which sign is considered a signature indicator of choanal atresia?
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What condition is characterized by the intestines being located in the thoracic cavity?
What condition is characterized by the intestines being located in the thoracic cavity?
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What nursing intervention is crucial in the management of gastrointestinal obstructions in infants?
What nursing intervention is crucial in the management of gastrointestinal obstructions in infants?
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Which of the following indicates an infant may have an anorectal malformation?
Which of the following indicates an infant may have an anorectal malformation?
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In which position should an infant be placed to prevent torsion of the intestines post-surgery for gastroschisis?
In which position should an infant be placed to prevent torsion of the intestines post-surgery for gastroschisis?
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What is a potential risk factor for congenital anomalies like omphalocele and gastroschisis?
What is a potential risk factor for congenital anomalies like omphalocele and gastroschisis?
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What is the first step in confirming a diagnosis of choanal atresia?
What is the first step in confirming a diagnosis of choanal atresia?
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Study Notes
Congenital Anomalies
- Defect present at birth caused by genetic or environmental factors
- 2-3% of live births
- Leading cause of infant deaths under 1 year of age
- No identifiable cause in 50% of congenital defects
- Most common congenital anomaly is cardiac defects
Central Nervous System Anomalies
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Encephalocele
- Herniation of the brain and meninges
- Usually found in the occipital area of the skull
- Often found with other congenital anomalies like cardiac defects, cleft lip and palate, microencephaly
- Treatment is surgery
- Shunt placed to remove excess cerebral spinal fluid (CSF)
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Anencephaly
- Most severe neural tube defect
- Absence of both cerebral hemispheres and the overlying skull
- Many are stillborn or incompatible with life
- Palliative care and family support provided
Respiratory System Anomalies
-
Diaphragmatic Hernia
- Intestines are in the chest cavity, compressing the lungs
- Symptoms include: barrel chest and scaphoid abdomen, asymmetric chest expansion, respiratory distress, displacement of heart sounds to the right, spasmodic attacks of cyanosis, difficulty feeding, and bowel sounds heard in thoracic cavity
- Nursing interventions include: maintaining adequate respiratory status, gastric decompression, placing infant in high semi-Fowler's position, turning to affected side, involving parents in care
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Choanal Atresia
- Most common nasal congenital anomaly
- Posterior nares blocked/obstructed by membrane or bone
- Symptoms include: cyanosis and retractions at rest, color improves with crying, noisy respirations, difficulty breathing during feeding, copious/thick mucous
- Nursing interventions include: passing feeding tube to confirm diagnosis (will not advance), insert oral airway, keep infant prone to prevent aspiration on secretions
Gastrointestinal System Anomalies
-
Omphalocele
- Herniated abdominal contents contained in the peritoneal sac
- Intestines only or contain liver and spleen
- May be associated with other congenital anomalies, chromosomal abnormalities like trisomies
- Common risk factors include young/advanced maternal age, obesity, use of SSRIs, alcohol or tobacco
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Gastroschisis
- Herniation of bowel through abdominal wall defect
- NOT usually associated with other congenital anomalies
- Common risk factors include: maternal age less than 20 years old, low maternal weight, IUGR, tobacco and drug use, genitourinary infections, exposure to agricultural chemicals
Nursing Interventions for Omphalocele and Gastroschisis
- Immediately cover with saline-soaked sterile gauze and plastic wrap to avoid insensible water loss
- Thermoregulation is important due to rapid heat loss
- Prevent infection
- Decompress gut with orogastric tube to low wall suction
- Monitor perfusion and position on the side with support to prevent torsion of intestines
GI Obstruction
- Obstructions can occur anywhere in the GI tract
- Symptoms include: bilious emesis, abdominal distention, failure to pass meconium, respiratory distress (if a high obstruction)
- Nursing Interventions include: holding feeds, placing orogastric tube to low wall suction, immediate surgical intervention (bowel resection or ostomy)
Anorectal Malformation
-
Imperforate Anus
- Infant does not pass meconium during the first 24 hours
- More common in males
- No anal opening or abnormally located
- Common fistula to the genitourinary tract
- Repair depends on location and if a thin membrane covers the anal opening
Genitourinary System Anomalies
-
Exstrophy of the Bladder
- Most common bladder anomaly
- Males are 2X more likely than females
- Epispadias often concurrent
- Immediately cover the exposed bladder with sterile gauze soaked in normal saline to keep it moist
- Surgical closure of the bladder often done within 48 hours after birth
- Staged surgical repairs completed before school age
Most Important Intervention for Congenital Anomalies of the Newborn:
-
Parental and family support
- Families are in crisis when they first see their newborn, even with pre-known diagnoses
- Deformities are emotionally traumatic
- Parents often blame themselves
- Grief and loss is common
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Nursing Theory to Support Families: Caring Theory
- Knowing: Understanding the loss for the family
- Being with: Caring presence and acceptance
- Doing for: Providing care for the mother and family
- Enabling: Providing information, guidance, and allowing parents to make choices
- Maintaining belief: Encourage the family's ability to overcome the loss
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Description
Explore the critical topics surrounding congenital anomalies, including their causes, prevalence, and impact on infant mortality. This quiz covers various types such as central nervous system anomalies and respiratory system anomalies, along with treatment options and care considerations. Test your knowledge on these important health issues.
